» Articles » PMID: 31859225

Patterns and Predictors of Older Adult Medicare Part D Beneficiaries' Receipt of Medication Therapy Management

Overview
Publisher Elsevier
Specialty Pharmacy
Date 2019 Dec 21
PMID 31859225
Citations 14
Authors
Affiliations
Soon will be listed here.
Abstract

Background: Medicare Part D medication therapy management (MTM) includes an annual comprehensive medication review (CMR) as a strategy to mitigate suboptimal medication use in older adults.

Objectives: To describe the characteristics of Medicare beneficiaries who were eligible, offered, and received a CMR in 2013 and 2014 and identify potential disparities.

Methods: This nationally representative cross-sectional study used a 20% random sample of Medicare Part A, B, and D data linked with Part D MTM files. A total of 5,487,343 and 5,822,188 continuously enrolled beneficiaries were included in 2013 and 2014, respectively. CMR use was examined among a subset of 620,164 and 669,254 of these beneficiaries enrolled in the MTM program in 2013 and 2014. Main measures were MTM eligibility, CMR offer, and CMR receipt. The Andersen Behavioral Model of Health Services Use informed covariates selected.

Results: In 2013 and 2014, 505,658 (82%) and 649,201 (97%) MTM eligible beneficiaries were offered a CMR, respectively. Among those, CMR receipt increased from 81,089 (16%) in 2013 to 119,181 (18%) in 2014. The mean age of CMR recipients was 75 years (±7) and the majority were women, White, and without low-income status. In 2014, lower odds of CMR receipt were associated with increasing age (adjusted odds ratio (OR) = 0.99 (95% confidence interval (CI) = 0.994-0.995), male sex (OR = 0.93, 95% CI = 0.926-0.951), being any non-White race/ethnicity except Black, dual-Medicaid status (OR = 0.64, 95% CI = 0.626-0.650), having a hospitalization (OR = 0.87, 95% CI = 0.839-0.893) or emergency department visit (OR = 0.67, 95% CI = 0.658-0.686), and number of comorbidities (OR = 0.90, 95% CI = 0.896-0.905).

Conclusions: CMR offers and completion rates have increased, but disparities in CMR receipt by age, sex, race, and dual-Medicaid status were evident. Changes to MTM targeting criteria and CMR offer strategies may be warranted to address disparities.

Citing Articles

Receipt of Medicare Part D comprehensive medication reviews in older adults with dementia.

Coe A, Martindale J, Bynum J J Manag Care Spec Pharm. 2025; 31(3):296-305.

PMID: 40021462 PMC: 11871161. DOI: 10.18553/jmcp.2025.31.3.296.


Applying the Andersen behavioral model to the medication therapy management program: an approach for improving medication safety in older adults.

Fu Y, Castora-Binkley M, Coe A, Snyder M, Cooke C, Vogel C Front Public Health. 2024; 12:1499362.

PMID: 39639895 PMC: 11619275. DOI: 10.3389/fpubh.2024.1499362.


Impact of comprehensive medication reviews on potentially inappropriate medication discontinuation in Medicare beneficiaries.

Hung A, Wilson L, Smith V, Pavon J, Sloan C, Hastings S J Am Geriatr Soc. 2024; 72(8):2347-2358.

PMID: 38826070 PMC: 11323205. DOI: 10.1111/jgs.19013.


Racial and ethnic disparities related to the Medicare Part D Medication Therapy Management Program.

Allen A, Hung A J Manag Care Spec Pharm. 2024; 30(6):609-616.

PMID: 38824629 PMC: 11144990. DOI: 10.18553/jmcp.2024.30.6.609.


Comprehensive Medication Review Completion Rates and Disparities After Medicare Star Rating Measure.

Hung A, Wilson L, Smith V, Pavon J, Sloan C, Hastings S JAMA Health Forum. 2024; 5(5):e240807.

PMID: 38700854 PMC: 11069085. DOI: 10.1001/jamahealthforum.2024.0807.


References
1.
Viswanathan M, Kahwati L, Golin C, Blalock S, Coker-Schwimmer E, Posey R . Medication therapy management interventions in outpatient settings: a systematic review and meta-analysis. JAMA Intern Med. 2014; 175(1):76-87. DOI: 10.1001/jamainternmed.2014.5841. View

2.
. American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2015; 63(11):2227-46. DOI: 10.1111/jgs.13702. View

3.
Brandt N, Cooke C . Centers for Medicare and Medicaid Services Support for Medication Therapy Management (Enhanced Medication Therapy Management): Testing Strategies for Improving Medication Use Among Beneficiaries Enrolled in Medicare Part D. Clin Geriatr Med. 2017; 33(2):153-164. DOI: 10.1016/j.cger.2017.01.001. View

4.
Buhl A, Augustine J, Taylor A, Martin R, Warholak T . Positive Medication Changes Resulting from Comprehensive and Noncomprehensive Medication Reviews in a Medicare Part D Population. J Manag Care Spec Pharm. 2017; 23(3):388-394. PMC: 10397760. DOI: 10.18553/jmcp.2017.23.3.388. View

5.
Taylor A, Axon D, Campbell P, Fair M, Nelson M, Boesen K . What Patients Know About Services to Help Manage Chronic Diseases and Medications: Findings from Focus Groups on Medication Therapy Management. J Manag Care Spec Pharm. 2018; 24(9):904-910. PMC: 10398267. DOI: 10.18553/jmcp.2018.24.9.904. View